When President Trump nominated federal judge Brett Kavanaugh to fill a soon-to-be-vacant Supreme Court spot, liberals responded with panic and fear over the possibility that another conservative justice could lead to a fundamental rollback of equal rights, particularly for women and lesbian, gay, bisexual, and transgender people.

But the erosion of equal rights isn't always as dramatic as a Supreme Court appointment. As the Sunlight Foundation reported Thursday, the Trump administration has removed critical language about sex discrimination from the Department of Health and Human Services (HSS) Office for Civil Rights website. The Office for Civil Rights is responsible for investigating complaints and enforcing federal civil rights laws that apply to doctors, hospitals, and other recipients of HHS funding.

Advocates say the deletion of that language could harm patients who now won't have essential information about their right to non-discriminatory healthcare treatment. They also suggest that the administration's decision to delete that language could be seen as a signal to health insurance companies, hospitals, and healthcare providers that certain anti-discrimination laws won't be enforced.

Jocelyn Samuels, former director of the Office for Civil Rights at the HHS, said the deletions reflect the Trump administration's pattern of reversing government policies and regulations that protect people from discrimination based on their sexual orientation and gender identity.

"I would say that these latest actions are part of a pattern of refusals to act on behalf of women or LGBT people"

The administration, for example, has withdrawn guidance on treating transgender students nondiscriminately in public schools, attempted to ban transgender people from serving in the military, sought to expand the type of behavior protected by religious refusal laws, and argued in court that gender identity and sexual orientation aren't included in employment discrimination laws.

"I would say that these latest actions removing text from the website are part of a pattern of refusals to act on behalf of women or LGBT people, in ways that are tremendously damaging to their health and wellbeing," said Samuels, who is currently executive director of the Williams Institute, a think tank at UCLA Law that conducts research on sexual orientation, gender identity law, and public policy.

The language was removed between March and August 2017, and its disappearance was first noted by the National Women’s Law Center. The Sunlight Foundation, which monitors changes to government resources, detailed the extent of deleted material in its new report.

The affected pages contained information about Section 1557 of the Affordable Care Act, a bureaucratic regulation that actually plays a huge role in protecting patients from discrimination.

The deleted language included information about sex discrimination on the basis of gender identity and pregnancy termination, guidance that helped insurance companies code treating transgender patients for claims, and training materials that educated healthcare professionals about discrimination laws.

The administration also removed mentions and descriptions of "sex stereotyping," which is discrimination based on expectations of how someone should behave according to their sex or gender. Sex stereotyping has been prohibited under civil rights laws since a 1989 Supreme Court case, but a patient or healthcare professional on HHS' civil rights website now has less information about the laws that protect patients from discrimination.

"These administrative changes can feel distant, but in many ways they’re things that are most close to our everyday lives," said Kelli Garcia, director of reproductive justice initiatives and senior counsel at the National Women's Law Center.

"This may be a harbinger of larger policy changes to come."

The government began deleting language from the HHS websites after a district court issued an injunction in late 2016 barring the Office of Civil Rights from enforcing portions of Section 1557 that related to gender identity and abortion. But Samuels said the changes went far beyond the ruling by removing language indicating that patients could still file lawsuits related to healthcare discrimination, and by deleting information about aspects of sex discrimination unaffected by the court’s decision.

Samuels fears that, among other things, these changes may discourage LGBT people from seeking healthcare, and she worries that they will empower providers who might turn away or discriminate against patients.

She also believes the deletions are likely a prelude to new government rules that will propose to effectively eliminate any protections for transgender patients. While the administration would have to finalize those rules after seeking public comment — and will certainly face challenges from advocacy groups like the National Women's Law Center — such a move would be unsurprising.

"This may be a harbinger of larger policy changes to come," said Samuels.

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